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Achieve Success with AHIP Final Exam Solutions for 2024/2025 R346,73
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Exam (elaborations)

Achieve Success with AHIP Final Exam Solutions for 2024/2025

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Achieve Success with AHIP Final Exam Solutions for 2024/2025

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  • June 11, 2024
  • December 25, 2024
  • 9
  • 2023/2024
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3  reviews

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By: alex71 • 5 months ago

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By: TheAlphanurse • 6 months ago

GREAT DOC!! DETAILED ANSWERS. VALUE FOR MONEY HONESTLY. GOOD WORK

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By: kihumba • 6 months ago

GREAT DOCUMENT. VERIFIED EXAM QUESTIONS. GREAT VALUE FOR MONEY

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1. Which of the following is the primary purpose of the Affordable
Care Act (ACA)?
A) To reduce the number of insurance providers in the marketplace
B) To provide health insurance coverage to uninsured individuals
C) To increase insurance premiums for all individuals
D) To eliminate Medicaid expansion
Answer: B) To provide health insurance coverage to uninsured
individuals
Rationale: The ACA's main goal is to increase the number of insured
Americans by expanding Medicaid, creating health insurance
exchanges, and introducing regulations to make insurance more
affordable and accessible.


2. What does a Health Maintenance Organization (HMO) typically
require for its policyholders?
A) A deductible for every visit to the doctor
B) Referrals from primary care doctors for specialist care
C) To pay for all medical services out of pocket
D) The ability to see any doctor without restrictions
Answer: B) Referrals from primary care doctors for specialist care
Rationale: HMOs generally require members to get a referral from their
primary care doctor before seeing a specialist, which helps control costs
and ensure coordinated care.


3. Which of the following is a key feature of a Preferred Provider
Organization (PPO)?
A) Lower cost for seeing out-of-network providers
B) No need for a referral to see specialists

,C) A strict network of healthcare providers
D) A higher deductible than other plans
Answer: B) No need for a referral to see specialists
Rationale: PPOs offer flexibility in choosing healthcare providers,
including specialists, without needing referrals, which differentiates
them from HMOs.


4. Under Medicare Part D, what type of coverage is provided?
A) Hospital care
B) Prescription drug coverage
C) Long-term care
D) Mental health services
Answer: B) Prescription drug coverage
Rationale: Medicare Part D provides coverage for prescription drugs,
helping beneficiaries pay for medications they need, and is available
through private insurance plans.


5. What is the purpose of the Health Insurance Portability and
Accountability Act (HIPAA)?
A) To prevent discrimination in the hiring process
B) To provide tax incentives for health insurers
C) To protect patient privacy and ensure data security
D) To expand government-funded healthcare programs
Answer: C) To protect patient privacy and ensure data security
Rationale: HIPAA ensures that patient health information is kept
confidential and secure, requiring healthcare providers to implement
safeguards and comply with strict data security measures.

,6. Which of the following is true about a High Deductible Health Plan
(HDHP)?
A) It has low monthly premiums and high out-of-pocket costs
B) It requires no deductible for healthcare services
C) It covers only preventive care
D) It is only available through employer-sponsored programs
Answer: A) It has low monthly premiums and high out-of-pocket costs
Rationale: HDHPs are characterized by lower premiums but higher
deductibles, which means individuals pay more out-of-pocket before
insurance starts covering most services.


7. Medicaid is primarily designed to provide health coverage for which
group of individuals?
A) Adults with high incomes
B) Low-income individuals and families
C) Seniors over the age of 65
D) Individuals with employer-sponsored insurance
Answer: B) Low-income individuals and families
Rationale: Medicaid is a joint federal and state program aimed at
providing health coverage to low-income individuals and families,
including children, pregnant women, the elderly, and people with
disabilities.


8. What does the term "coinsurance" refer to in health insurance?
A) A fixed amount you pay for a covered healthcare service
B) A percentage of costs that you pay after meeting your deductible
C) The maximum amount a policyholder can be required to pay for

, healthcare services
D) A portion of the insurance premium that is paid by the employer
Answer: B) A percentage of costs that you pay after meeting your
deductible
Rationale: Coinsurance is the percentage of costs you pay for a
healthcare service after you've met your deductible. For example, if
your coinsurance is 20%, you pay 20% of the cost while the insurer
covers the remaining 80%.


9. The primary goal of the Children's Health Insurance Program (CHIP)
is to:
A) Provide health coverage for all adults under the age of 40
B) Offer health insurance to children in low-income families
C) Cover only uninsured children in high-income families
D) Expand access to long-term care for children with disabilities
Answer: B) Offer health insurance to children in low-income families
Rationale: CHIP provides low-cost health insurance to children in
families whose income is too high to qualify for Medicaid but too low to
afford private coverage.


10. Which of the following is an example of a managed care plan?
A) A fee-for-service plan
B) A health savings account (HSA)
C) An exclusive provider organization (EPO)
D) A catastrophic health plan
Answer: C) An exclusive provider organization (EPO)
Rationale: EPOs are a type of managed care plan that limits members

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